CANYON COUNTY ORAL MAXILLOFACIAL SURGERY, INC
Organization (NPI-2)
Active
Dentist, Oral and Maxillofacial Pathology
Provider Information
- NPI Number
1710184783- Provider Type
- Organization / Facility (NPI-2)
- Status
- Active
Contact & Location
- Address
- 4121 CLOCK TOWER AVE, CALDWELL, ID, 836075006
- Phone
- (208) 459-7800
Specialties & Taxonomies
Dentist, Oral and Maxillofacial Pathology
Primary License: ID #D3848OS